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General NPI Number Information
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NPI Number | 1831201854
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Entity Type | Organization
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Legal Business Name | KINSTON ORTHOPAEDIC & SPORTS MEDICINE CENTER, P.A.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/12/2007
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Provider Practice Location Address
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Address Line | 701 DOCTORS DR SUITE G
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City | KINSTON
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State | NC
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Zip | 28501-1584
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Country | US
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Telephone | 252-522-2020
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Fax | 252-527-7133
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Provider Business Mailing Address
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Address Line | 701 DOCTORS DR SUITE G
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City | KINSTON
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State | NC
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Zip | 28501-1584
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Country | US
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Telephone | 252-522-2020
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Fax | 252-527-7133
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES HENRY CLASSEN JR.
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Credential | M.D.
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Telephone | 252-522-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 39225
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License Number State | NC
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